Provider Demographics
NPI:1922725985
Name:MUSA-SAHATQIJA, BLERTA
Entity Type:Individual
Prefix:DR
First Name:BLERTA
Middle Name:
Last Name:MUSA-SAHATQIJA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 QUARRY ST APT 716
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4154
Mailing Address - Country:US
Mailing Address - Phone:347-415-9362
Mailing Address - Fax:
Practice Address - Street 1:100 MEDWAY RD STE 203
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2923
Practice Address - Country:US
Practice Address - Phone:508-478-2131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1859646122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist